can sexuality change?

Does sexuality change naturally?Some people do experience a shift in sexual attractions from homosexual to heterosexual or vice versa. In a recent paper for the Archive of Sexual Behaviour, Michael King (who is the chair of the Royal College of Psychiatrists’ Gay and Lesbian Special Interest Group and openly homosexual) and others looked at the correlation between how men and women described their sexual orientation, and alongside that gave a report of their sexual partnership status. Of the almost 3,500 participants who described themselves as ‘entirely heterosexual’ or ‘mostly heterosexual’, over 20 said that their choice for sexual partner was ‘mainly same sex’ or ‘only same sex’. This constituted 0.6% of the population. However, when the same question was asked of the 44 participants who described themselves as ‘mostly homosexual’ or ‘entirely homosexual’, eight said that their choice of sexual partner was ‘only opposite sex’ or ‘more often opposite sex’. This constituted almost 20% of the group of 44, or proportionally 30 times as many as those who were heterosexual but mainly had homosexual relationships.However, when people were asked to describe themselves as gay or lesbian rather than homosexual, only one of the 29 people who described themselves as gay or lesbian said their sexual relationships were exclusively or mainly heterosexual (now only approximately 3%). This may suggest that around a third of those who experienced mainly or exclusively homosexual attraction did not want to describe themselves as gay or lesbian (a reduction from 1.2% to 0.8%).Another significant study is the 2003 piece by Dickson, Paul and Herbison where, as part of a cohort study of women born 1972/1973, the researchers explored sexual behaviour over time. One of their findings is expressed in the diagram below.

Of the eight women who at age 21 claimed a major attraction to those of the same sex, five years later two of them (25%) now claimed to be exclusively opposite-sex attracted, and a further three (37.5%) claimed only to have occasional same-sex attractions. Meanwhile, three of the 390 women (< 1%) who reported exclusive heterosexual attraction at age 21 reported major homosexual attraction at age 26, and a further 42 (just over 10%) reported some homosexual attraction.

A ten-year US longitudinal study by Mock and Eibach also built up a picture of a bipolar sexual orientation spectrum with transition both ways. Transition was far more likely from homosexual/bisexual towards another orientation than from heterosexuality towards bisexuality/homosexuality. This effect is more pronounced amongst women than men.

More recent research by Lisa Diamond indicates that even amongst men and women who identify as exclusively homosexual, there are large proportions who also report sexual encounters with those of the opposite sex.

Can sexuality change through therapy?The main longitudinal study of so-called ‘reparative therapy’ was carried out by Stanton Jones and Mark Yarhouse. This research used psychotherapy industry standard measures to assess whether sexual orientation of participants changed, and whether the therapy caused psychological harm to the participants.

On average, Jones and Yarhouse observed a small recordable orientation shift in those who participated, but not a significant one. However, for those who began the therapy self-reporting as almost exclusively homosexual in their attractions, there was a more noticeable shift in orientation that was significant. This seemed to indicate that therapy was more likely to be successful at helping those who had exclusive homosexuality to develop some heterosexual feelings, but it didn’t provide anything like a ‘gay to straight’ outcome.

At the time, sexual orientation was usually measured on a single bipolar scale between exclusively homosexual and exclusively heterosexual (the so-called Kinsey Scale). But when participants were asked to measure homosexual attraction and heterosexual attraction on separate scales (i.e. not in relation to each other) then the change was more substantial. For the whole population there was a significant reduction in homosexual attraction. The more pronounced a participant’s homosexual orientation was to begin with, the more pronounced the reduction in their homosexual attraction. However, there was no significant increase in heterosexual attraction, though on average participants did record some increase.

Jones and Yarhouse also asked participants to report what they felt were the results of the therapy. Over two-thirds of the participants reported a positive desired change with respect to their sexuality. NB this included now being able to live a chaste life, or feeling positive about continuing in therapy. One in eight of the participants reported that they had rejected the premise of the therapy and were definitely gay, or that they were confused about their sexual identity. Significantly, not only was there no clinical evidence that reparative therapy caused harm, there was a significant decrease in the distress reported by participants.

SummarySo, studies of homosexuals who haven’t sought to change their orientation show that for some people sexuality changes naturally over the years. Specifically, female homosexuality seems to be more fluid than male. This fits with the twin studies which suggest a potentially higher environmental factor for homosexuality amongst women than men.

Where people have tried to change through therapy the evidence is that some experience change when they participate. Whilst some have not experienced much or any change in their sexual feelings, there has been real change for a minority, whether in terms of a reduction in the strength of their same-sex attractions, an increase in their opposite-sex attraction, or both. Certainly, the best longitudinal study so far found no evidence that such therapy is psychologically damaging, even where it does not achieve the results the participant wanted, and it can have other benefits such as reducing the person’s distress. So, whilst therapeutic approaches which seek to change sexual orientation have no guarantee of success, there is no reason for people not to have such therapy where they wish to do so. Of course, people need to be informed and realistic about the potential outcomes, as they should be when entering any therapy, and the therapy must be responsible and professional.